AccessGUDID - DEVICE: Provicol QM Plus (E22110981)

GUDID

Device Identifier (DI) Information

Brand Name: Provicol QM Plus
Version or Model: 1098
Commercial Distribution Status: In Commercial Distribution
Catalog Number: 1098
Company Name: VOCO GmbH

Primary DI Number: E22110981
Issuing Agency: HIBCC
Commercial Distribution End Date:
Device Count: 1
Labeler D-U-N-S® Number*: 316699578 *Terms of Use

Device Description: Eugenol-free temporary luting cement with calcium hydroxide.

Device Characteristics

What MRI safety information does the labeling contain?	Labeling does not contain MRI Safety Information
Device required to be labeled as containing natural rubber latex or dry natural rubber (21 CFR 801.437):	No
Device labeled as "Not made with natural rubber latex":	No
For Single-Use:	No
Prescription Use (Rx):	Yes
Over the Counter (OTC):	No
Kit:	No
Combination Product:	No
Human Cell, Tissue or Cellular or Tissue-Based Product (HCT/P):	No

GMDN

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GMDN Names and Definitions: © Copyright GMDN Agency 2015. Reproduced with Permission from the GMDN Agency.

GMDN Preferred Term Name	GMDN Definition
Fatty acid dental cement	A non-sterile, non-aqueous substance containing fatty acids typically with a mixture of oxides or hydroxides of zinc, magnesium, and/or calcium, that cures upon the acid/base reaction of its components and is intended to be used in a professional setting for the temporary luting of prefabricated dental crowns and bridges, but may also be used for the temporary filling of small cavities. It is typically available as a two-component device that can be hand mixed or auto-mixed (using a dispenser with mixing nozzle) into a paste. After application, this device cannot be reused.

GMDN Preferred Term Name

GMDN Definition

Fatty acid dental cement

A non-sterile, non-aqueous substance containing fatty acids typically with a mixture of oxides or hydroxides of zinc, magnesium, and/or calcium, that cures upon the acid/base reaction of its components and is intended to be used in a professional setting for the temporary luting of prefabricated dental crowns and bridges, but may also be used for the temporary filling of small cavities. It is typically available as a two-component device that can be hand mixed or auto-mixed (using a dispenser with mixing nozzle) into a paste. After application, this device cannot be reused.

FDA Product Code

[?]

Product Code	Product Code Name
EMB	Zinc Oxide Eugenol

FDA Premarket Submission

FDA Premarket Submission Number [?]	Supplement Number [?]
K161630	000

Device Exempt from Premarket Submission: No CLOSE

Sterilization

Device Packaged as Sterile: No
Requires Sterilization Prior to Use: No

Sterilization Method [?]
No Sterilization Methods Found

Storage and Handling

[?]

Storage and Handling
Storage Environment Temperature: between 4 and 23 Degrees Celsius

Clinically Relevant Size

[?]

Size Type Text
Weight: 250 Gram

Device Record Status

Public Device Record Key: bd2b22fc-2eb9-4836-98eb-f9b2f2c7f932
Public Version Date: July 06, 2018
Public Version Number: 3
DI Record Publish Date: October 31, 2016